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Mauclet C, Dupont MV, Roelandt K, Regnier M, Delos M, Pirard L, Vander Borght T, Dahlqvist C, Froidure A, Rondelet B, Vanderick J, Remouchamps V, Duplaquet F, Ocak S. Treatment and Prognosis of Patients with Lung Cancer and Combined Interstitial Lung Disease. Cancers (Basel) 2023; 15:3876. [PMID: 37568692 PMCID: PMC10417812 DOI: 10.3390/cancers15153876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Interstitial lung disease (ILD) is associated with a higher lung cancer (LC) risk and may impact cancer's clinical characteristics, treatment strategies, and outcomes. This impact's extent is unclear, particularly in Caucasians. METHODS In this retrospective observational study, we reviewed the files of all LC patients diagnosed in a 38-month period. Expert radiologists reviewed the computed tomography scans performed at diagnosis. Patients with LC and ILD (n = 29, 7%) were compared to those without ILD (n = 363, 93%) for population and cancer characteristics, treatments, and clinical outcomes. RESULTS Patients with LC and ILD were older (73 ± 8 vs. 65 ± 11 years; p < 0.001). There was no significant difference in LC histology, localization, stage, or treatment modalities. The respiratory complication rate after cancer treatment was significantly higher in the ILD group (39% vs. 6%; p < 0.01). Overall survival rates were similar at 12 (52% vs. 59%; p = 0.48) and 24 months (41% vs. 45%; p = 0.64) but poorer in the ILD group at 36 months, although not statistically significant (9% vs. 39%; p = 0.06). The ILD group had a higher probability of death (hazard ratio (HR) = 1.49 [0.96;2.27]), but this was not statistically significant (p = 0.06). In a Cox regression model, patients with ILD treated surgically had a significantly higher mortality risk (HR = 2.37 [1.1;5.09]; p = 0.03). CONCLUSIONS Patients with combined LC and ILD have worse clinical outcomes even when similar treatment modalities are offered.
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Affiliation(s)
- Charlotte Mauclet
- Division of Pulmonology, Clinique Saint-Luc Bouge, Rue Saint-Luc, 8, 5004 Namur, Belgium
| | - Michaël V. Dupont
- Division of Radiology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (M.V.D.); (K.R.)
| | - Kerwin Roelandt
- Division of Radiology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (M.V.D.); (K.R.)
| | - Maxime Regnier
- Scientific Support Unit, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium;
| | - Monique Delos
- Division of Pathology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium;
| | - Lionel Pirard
- Division of Pulmonology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (L.P.); (C.D.); (F.D.); (S.O.)
| | - Thierry Vander Borght
- Division of Nuclear Medicine, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium;
| | - Caroline Dahlqvist
- Division of Pulmonology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (L.P.); (C.D.); (F.D.); (S.O.)
| | - Antoine Froidure
- Division of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 10, 1200 Bruxelles, Belgium;
- Pole of Pulmonology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 55/B1.55.02, 1200 Bruxelles, Belgium
| | - Benoît Rondelet
- Division of Thoracic Surgery, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium;
| | - Jean Vanderick
- Division of Radiation Therapy, CHU UCL Namur (Sainte-Elisabeth Site), Université Catholique de Louvain (UCLouvain), Place Louise Godin, 15, 5000 Namur, Belgium; (J.V.); (V.R.)
| | - Vincent Remouchamps
- Division of Radiation Therapy, CHU UCL Namur (Sainte-Elisabeth Site), Université Catholique de Louvain (UCLouvain), Place Louise Godin, 15, 5000 Namur, Belgium; (J.V.); (V.R.)
| | - Fabrice Duplaquet
- Division of Pulmonology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (L.P.); (C.D.); (F.D.); (S.O.)
| | - Sebahat Ocak
- Division of Pulmonology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium; (L.P.); (C.D.); (F.D.); (S.O.)
- Pole of Pulmonology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 55/B1.55.02, 1200 Bruxelles, Belgium
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Assié JB, Chouaïd C, Nunes H, Reynaud D, Gaudin AF, Grumberg V, Jolivel R, Jouaneton B, Cotté FE, Duchemann B. Outcome following nivolumab treatment in patients with advanced non-small cell lung cancer and comorbid interstitial lung disease in a real-world setting. Ther Adv Med Oncol 2023; 15:17588359231152847. [PMID: 36743523 PMCID: PMC9893351 DOI: 10.1177/17588359231152847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023] Open
Abstract
Background Up to 10% of patients with advanced non-small cell lung cancer (aNSCLC) have pre-existing interstitial lung disease (ILD). These patients are usually excluded from immunotherapy clinical trials. Consequently, knowledge on outcomes following nivolumab treatment in these patients remains limited. The primary objective of this study was to evaluate survival outcome following nivolumab treatment in ILD patients with pre-treated aNSCLC in the real-world setting. Patients and methods The study included all patients with aNSCLC recorded in the French hospital database, starting nivolumab in 2015-2016. Patients were stratified by pre-existing ILD and three subgroups were studied [auto-immune or granulomatous (AI/G) ILD, other known causes ILD and idiopathic ILD]. Time to discontinuation of nivolumab treatment [time to treatment duration (TTD)] and overall survival (OS) were estimated using Kaplan-Meier survival analysis. Results Of 10,452 aNSCLC patients initiating nivolumab, 148 (1.4%) had pre-existing ILD. Mean age at nivolumab initiation was 64.6 ± 9.4 years in ILD and 63.8 ± 9.6 years in non-ILD. Compared to non-ILD, patients in the ILD group were more frequently men (p < 0.05) and had more comorbidities (p < 0.001). There was no significant difference between ILD and non-ILD groups for median TTD (2.5 versus 2.8 months; p = 0.6) or median OS (9.6 versus 11.9 months; p = 0.1). Median OS in AI/G ILD (n = 14), other known causes ILD (n = 75), and idiopathic ILD (n = 59) were 8.6, 10.7, and 9.6 months, respectively. Conclusion In this large cohort of aNSCLC patients with ILD, outcomes are similar to those obtained in the non-ILD population. Immunotherapy could be beneficial for these patients.
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Affiliation(s)
- Jean-Baptiste Assié
- Functional Genomics of Solid Tumors Laboratory, Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France,Centre Hospitalier Intercommunal Créteil, Créteil, France
| | | | - Hilario Nunes
- Department of Respiratory Medicine, Centre de Référence des Maladies Pulmonaires Rares, Avicenne Hospital, Université Sorbonne Paris Nord, Paris, France
| | | | | | | | | | | | | | - Boris Duchemann
- Department of Thoracic and Medical Oncology, Avicenne Hospital, Université Sorbonne Paris Nord, Paris, France,Laboratoire d’Immunomonitoring en Oncologie, INSERM US23, CNRS UMS 3655, Institut Gustave Roussy, Villejuif, France
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Crestani B, Kolb M. Lung cancer in pulmonary fibrosis: no room for nihilism! Eur Respir J 2022; 60:2201946. [PMID: 36522141 DOI: 10.1183/13993003.01946-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 12/16/2022]
Affiliation(s)
- Bruno Crestani
- Service de Pneumologie A, Centre de référence constitutif des maladies pulmonaires rares, Hôpital Bichat, APHP, Paris, France
- Université Paris Cité, Inserm 1152, PHERE, Paris, France
| | - Martin Kolb
- Department of Respiratory Medicine, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, ON, Canada
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Nigen B, Chéné AL, Liberge R, Sagan C, Blanc FX. [Immune-related pneumonitis: A differential diagnosis of SARS-CoV-2 pneumonia]. Rev Mal Respir 2022:S0761-8425(22)00258-3. [PMID: 35906150 DOI: 10.1016/j.rmr.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/04/2022] [Indexed: 12/17/2022]
Abstract
Introduction Les inhibiteurs de points de contrôle immunitaire ont révolutionné la prise en charge de nombreux cancers et ont permis d’obtenir une efficacité et une réponse durable pour certains patients. L’immunothérapie est associée à des effets secondaires en lien avec l’infiltration de cellules immunitaires dans les tissus normaux pouvant entraîner des réactions dysimmunitaires disproportionnées. Ces effets secondaires peuvent toucher n’importe quel organe, dont le poumon, pouvant parfois engager le pronostic vital. Ils peuvent ressembler à des événements de nature infectieuse, dont la COVID-19. Observations Nous rapportons le cas de 3 patients ayant présenté des toxicités pulmonaires sévères secondaires à l’immunothérapie entre mars et mai 2020 avec hypothèse initiale d’une pneumopathie à SARS-CoV-2. Après investigations approfondies, le diagnostic de toxicité pulmonaire à l’immunothérapie fut retenu, avec une évolution clinique et radiologique favorable suite à l’instauration d’une corticothérapie. Conclusion La toxicité pulmonaire secondaire à l’immunothérapie reste un effet indésirable rare, mais pouvant engager le pronostic vital. La démarche diagnostique impose d’éliminer plusieurs diagnostics différentiels. Le tableau clinique est réversible et l’évolution habituellement favorable après instauration d’une corticothérapie.
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Zhang Q, Tong L, Wang B, Wang T, Ma H. Diagnostic Value of Serum Levels of IL-22, IL-23, and IL-17 for Idiopathic Pulmonary Fibrosis Associated with Lung Cancer. Ther Clin Risk Manag 2022; 18:429-437. [PMID: 35469293 PMCID: PMC9034872 DOI: 10.2147/tcrm.s349185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Qian Zhang
- Pneumology Department, The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi City, People’s Republic of China
| | - Lihong Tong
- Pneumology Department, The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi City, People’s Republic of China
| | - Bing Wang
- Pneumology Department, The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi City, People’s Republic of China
| | - Ting Wang
- Pneumology Department, The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi City, People’s Republic of China
| | - Hongxia Ma
- Pneumology Department, The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi City, People’s Republic of China
- Correspondence: Hongxia Ma, Pneumology Department, The Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi City, The Xinjiang Uygur Autonomous Region, 830000, People’s Republic of China, Email
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Abstract
Tumor immunotherapy is considered to be a novel and promising therapy for tumors and it has recently become a hot research topic. The clinical success of tumor immunotherapy has been notable, but it has been less than totally satisfactory because tumor immunotherapy has performed poorly in numerous patients although it has shown appreciable efficacy in some patients. A minority of patients demonstrate durable responses but the majority of patients do not respond to tumor immunotherapy as the tumor immune microenvironment is different in different patients for different tumor types. The success of tumor immunotherapy may be affected by the heterogeneity of the tumor immune microenvironment and its components, as these vary widely during neoplastic progression. The deepening of research and the development of technology have improved our understanding of the complexity and heterogeneity of the tumor immune microenvironment and its components, and their effects on response to tumor immunotherapy. Therefore, investigating the tumor immune microenvironment and its components and elucidating their association with tumor immunotherapy should improve the ability to study, predict and guide immunotherapeutic responsiveness, and uncover new therapeutic targets.
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Affiliation(s)
- Changsheng Zhou
- Department of Hepatobiliary Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, P.R. China.,Department of Hepatobiliary Surgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China.,School of Medicine, Xiamen University, Xiamen, Fujian 361102, P.R. China.,Cancer Research Center of Xiamen University, Xiamen University, Xiamen, Fujian 361102, P.R. China.,Retroperitoneal Tumor Research Center of Oncology Chapter of Chinese Medical Association, Xiamen University, Xiamen, Fujian 361102, P.R. China
| | - Qianqian Liu
- Department of Hepatobiliary Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, P.R. China.,School of Medicine, Xiamen University, Xiamen, Fujian 361102, P.R. China
| | - Yi Xiang
- Department of Hepatobiliary Surgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China
| | - Xin Gou
- Department of Hepatobiliary Surgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou 550002, P.R. China
| | - Wengang Li
- Department of Hepatobiliary Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, P.R. China.,School of Medicine, Xiamen University, Xiamen, Fujian 361102, P.R. China.,Cancer Research Center of Xiamen University, Xiamen University, Xiamen, Fujian 361102, P.R. China.,Retroperitoneal Tumor Research Center of Oncology Chapter of Chinese Medical Association, Xiamen University, Xiamen, Fujian 361102, P.R. China
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Ikeda S, Kato T, Kenmotsu H, Sekine A, Baba T, Ogura T. Current Treatment Strategies for Non-Small-Cell Lung Cancer with Comorbid Interstitial Pneumonia. Cancers (Basel) 2021; 13:3979. [PMID: 34439135 PMCID: PMC8393888 DOI: 10.3390/cancers13163979] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
Of patients with advanced non-small-cell lung cancer (NSCLC), 5-10% have interstitial pneumonia (IP) at the time of diagnosis. To avoid fatal acute exacerbations of pre-existing IP, appropriate patient selection and low-risk treatment choices are warranted. Risk factors for acute exacerbation of pre-existing IP with cytotoxic drugs include honeycomb lungs on computed tomography (CT) and low forced vital capacity, but risk factors with immune checkpoint inhibitors (ICIs) have not been fully investigated. For advanced or recurrent NSCLC with comorbid IP, carboplatin plus nanoparticle albumin-bound paclitaxel is the standard of care for first-line treatment, but second-line or later treatment has not been established. ICI holds great promise for long-term survival, but many challenges remain, including safety and appropriate patient selection. Since the indications for pharmacotherapy and radiotherapy for NSCLC with comorbid IP are quite limited, surgical resection should be considered as much as possible for patients with operable stages. A scoring system has been reported to predict the risk of postoperative acute exacerbation of pre-existing IP, but perioperative treatment has not been established. In the future, it is necessary to accumulate more cases and conduct further research, not only in Japan but also worldwide.
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Affiliation(s)
- Satoshi Ikeda
- Kanagawa Cardiovascular and Respiratory Center, Department of Respiratory Medicine, 6-16-1, Tomioka-higashi, Kanazawa-ku, Kanagawa 236-0051, Japan; (A.S.); (T.B.); (T.O.)
| | - Terufumi Kato
- Kanagawa Cancer Center, Department of Thoracic Oncology, 2-3-2, Nakao, Asahi-ku, Kanagawa 241-8515, Japan;
| | - Hirotsugu Kenmotsu
- Division of Thoracic Oncology, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Shizuoka 411-8777, Japan;
| | - Akimasa Sekine
- Kanagawa Cardiovascular and Respiratory Center, Department of Respiratory Medicine, 6-16-1, Tomioka-higashi, Kanazawa-ku, Kanagawa 236-0051, Japan; (A.S.); (T.B.); (T.O.)
| | - Tomohisa Baba
- Kanagawa Cardiovascular and Respiratory Center, Department of Respiratory Medicine, 6-16-1, Tomioka-higashi, Kanazawa-ku, Kanagawa 236-0051, Japan; (A.S.); (T.B.); (T.O.)
| | - Takashi Ogura
- Kanagawa Cardiovascular and Respiratory Center, Department of Respiratory Medicine, 6-16-1, Tomioka-higashi, Kanazawa-ku, Kanagawa 236-0051, Japan; (A.S.); (T.B.); (T.O.)
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Ikeda S, Kato T, Kenmotsu H, Okamoto H, Ogura T. Re: Immune checkpoint blockade for patients with lung cancer and idiopathic pulmonary fibrosis. Eur J Cancer 2021; 151:249-251. [PMID: 33962866 DOI: 10.1016/j.ejca.2021.03.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/01/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Satoshi Ikeda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1, Tomioka-higashi, Kanazawa-ku, Yokohama-city, Kanagawa Prefecture, 236-0051, Japan.
| | - Terufumi Kato
- Department of Thoracic Oncology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ku, Yokohama-city, Kanagawa Prefecture, 241-8515, Japan
| | - Hirotsugu Kenmotsu
- Division of Thoracic Oncology, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka Prefecture, 411-8777, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56, Okazawa-cho, Hodogaya-ku, Yokohama-city, Kanagawa Prefecture, 221-0855, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1, Tomioka-higashi, Kanazawa-ku, Yokohama-city, Kanagawa Prefecture, 236-0051, Japan
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